ArticleJournal of affective disorders2022
Network analysis of comorbid depression and anxiety and their associations with quality of life among clinicians in public hospitals during the late stage of the COVID-19 pandemic in China.
Article in Journal of affective disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers.
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52 citing papers in PubMed, 79 citations in OpenAlex.
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- Relationship between depression, anxiety and emotional exhaustion among infectious disease nurses: a network analysis.BMC psychiatry · 2026Article
- Association of dietary patterns and healthy diet scores with anxiety, depression, and their comorbidity among rural Chinese adults.BMC public health · 2026Article
- The relationship between openness to experience and college students' well-being: the mediating roles of art-related aesthetic perception and needs.Frontiers in psychology · 2026Article
- Longitudinal relationship between anxiety symptoms and occupational burnout dimensions among newly hired nurses: a cross-lagged network analysis.Frontiers in psychiatry · 2026Article
- Exploring the interrelationships between athlete burnout, depression, and anxiety: a network analysis approach.Frontiers in psychology · 2026Article
- The internal structure of transformational leadership as perceived by clinical nurses: a network analysis.Frontiers in psychology · 2026Article
- Ability and utility of the Physician Well-Being Index to identify distress among Chinese physicians.Annals of medicine · 2025Article
- Cross-Informant Comparison of Depressive Symptoms in Youth: A Network Approach.PsyCh journal · 2025Article
- Network analysis of interrelationships among physical activity, sleep disturbances, depression, and anxiety in college students.BMC psychiatry · 2025Article
- A network analysis study of anxiety, depression and loneliness among middle-aged and elderly people in Xining area.BMC psychology · 2025Article
- Anxiety and Depression Among College Students Before and After the COVID-19 Pandemic Lockdown Lift: A Network Analysis Study Focus on the Transition Period.PsyCh journal · 2025Article
- Perceived stress shapes symptom and social network dynamics: a network analysis of depression, anxiety, and relationship-specific support and strain.BMC psychiatry · 2025Article
- Network analysis of depression and anxiety symptoms and their associations with cognitive fusion among pregnant women.BMC psychiatry · 2025Article
- A simulation-based network analysis of intervention targets for comorbid symptoms of depression and anxiety in Chinese healthcare workers in the post-dynamic zero-COVID policy era.BMC psychiatry · 2025Article
- The association between adaptability and the symptoms of depression and anxiety in early adolescents: a network analysis in a longitudinal design.BMC psychiatry · 2025Article
- A network analysis of postpartum depression and mother-to-infant bonding shows common and unique symptom-level connections across three postpartum periods.Communications psychology · 2025Article
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Authors and funding
11 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMental health problems are common among clinicians working in public hospitals even in the late stage of the COVID-19 pandemic. Network analysis is a novel approach to explore interactions between mental health problems at the symptom level. This study examined the network structure of comorbid depression and anxiety and their associations with quality of life (QOL) among hospital clinicians in China during the late stage of the COVID-19 pandemic.
methodsA total of 4931 participants were recruited from October 13 to 22, 2020. The nine-item Patient Health Questionnaire (PHQ-9), seven-item Generalized Anxiety Disorder Scale (GAD-7), and the World Health Organization Quality of Life Questionnaire-Brief Version (WHOQOL-BREF) were used to measure depressive and anxiety symptoms, and QOL, respectively. Central and bridge symptoms were identified with centrality and bridge centrality indices, respectively. Network stability was examined using the case-dropping procedure.
resultsThe prevalence of depression (defined as PHQ-9 total score ≥ 5) was 35.1 % [95 % confidence interval (CI) = 33.73-36.41 %)], the prevalence of anxiety (GAD-7 total score ≥ 5) was 32.5 % (95 % CI = 31.20-33.84 %), while the prevalence of comorbid depression and anxiety was 26.9 % (95 % CI = 25.7-28.2 %). "Impaired motor skills", "Trouble relaxing" and "Uncontrollable worry" were the central symptoms in the whole depression-anxiety network. "Irritability", "Feeling afraid" and "Sad mood" were the most key bridge symptoms linking depression and anxiety. Three symptoms ("Fatigue", "Trouble relaxing" and "Nervousness") were the most strongly and negatively associated with QOL. Neither gender nor the experiences of caring for COVID-19 patients was associated with network global strength, distribution of edge weights or individual edge weights. LIMITATIONS: The causality between variables could not be established. Depressive and anxiety symptoms were assessed by self-report measures, which may result in recall bias and limitations in capturing clinical phenomena.
conclusionsBoth the central (i.e., "Impaired motor skills", "Trouble relaxing" and "Uncontrollable worry") and bridge symptoms (i.e., "Irritability", "Feeling afraid" and "Sad mood") identified in this network analysis should be targeted in specific treatment and preventive measures for comorbid depressive and anxiety symptoms among clinicians in the late stage of the pandemic. Furthermore, "Fatigue", "Trouble relaxing" and "Nervousness" are key symptoms to address to improve clinicians' QOL.
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